Provider First Line Business Practice Location Address:
1504 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REDDING
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96001-1023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-244-4407
Provider Business Practice Location Address Fax Number:
844-265-1995
Provider Enumeration Date:
12/21/2012